| Name: | Kilgore Express Pharmacy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 14 Jan 2003 (22 years ago) |
| Entity Number: | 000-226-918 |
| Register Number: | 000226918 |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Registered Office Street Address: | HIGHWAY 35 & 75RAINSVILLE, AL 35986 |
| Registered Office Street Address ZIP Code: | 35986 |
| Registered Office Mailing Address: | P O BOX 129RAINSVILLE, AL 35986 |
| Registered Office Mailing Address ZIP Code: | 35986 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PHARMACY BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730415142 | 2009-10-20 | 2009-10-20 | PO BOX 680905, FORT PAYNE, AL, 359681610, US | 1614 GLENN BLVD SW, FORT PAYNE, AL, 359683522, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 256-845-6640 |
| Fax | 2568459796 |
| Phone | +1 256-845-3402 |
| Fax | 2568453289 |
Authorized person
| Name | LOTHA KILGORE |
| Role | PHARMACIST/OWNER |
| Phone | 2568453402 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113311 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 0136209 |
| Name | Role | Address |
|---|---|---|
| KILGORE, LOTHA | Agent | PO BOX 680905FORT PAYNE, AL 35968 |
| Name | Role | Address |
|---|---|---|
| KILGORE, LOTHA | Incorporator | PO BOX 680905FORT PAYNE, AL 35968 |
| KILGORE, MITCHELL | Incorporator | 37 GRIME STREETRAINSVILLE, AL 35986 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
